Acute abdominal pain

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This presentation is made by Dr Ashok Jaisingani for study purpose if any one like this than please give comments.

This presentation is made by Dr Ashok Jaisingani for study purpose if any one like this than please give comments.

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  • 1. Acute Abdominal Pain Dr. Ashok Jaisingani
  • 2. Introduction► Between one-third to one-half of the child admitted hospital for acute abdominal pain have non-specific abdominal pain.► Another one-third have acute appendicitis.► Other relatively benign condition also cause abdominal pain such as constipation, urinary tract infection account for most of remain.
  • 3. Work-up Of child with Acute Abdominal Pain► A careful history and examination and active observation are paramount.► Routine test include urine analysis, microscopy and culture.► Frequently helpful tests such as abdominal ultrasound scan can diagnose pelvic, UTI and GIT pathology.► Occasionally helpful a plain supine radiograph particularly in preschool child with pain and vomiting, urea and electrolytes and CBC.► Selective specific investigation are blood culture, stool culture, plasma amylase and diagnostic laparoscopy.
  • 4. Acute Non – Specific Abdominal Pain► Pain is poorly localized, not aggravated by movement and rarely accompanied by guarding.► Site and severity of maximum tenderness often vary during the course of repeated examination.► Symptoms are usually self limiting within 24h.► The etiology of non-specific pain in children is obscure but viral infection and transitient intussusception are account for some cases.► Mesenteric adenitis a viral infection causing widespread 1- Reactive lymphadenopathy 2- Fever 3- Diffuse Abdominal Pain.
  • 5. Other Causes Of Acute Abdominal Pain► Intestinal Obstruction► Constipation► Urinary Tract Infection► Gastroenteritis► Tropical Disease► There are numerous rare cause of abdominal pain in children are 1- Henoch-schonlen purpura 2- Sickle Cell Disease 3- Primary peritonitis, acute pancreatitis and biliary colic 4- Testicular torsion and gynecological pathology 5- Urinary stone disease.
  • 6. Intestinal Obstruction► Intestinalobstruction in children caused by► Intussusception► Inguinal Hernia► Adhesion► Meckel’s diverticulum
  • 7. Constipation► The passage of hard or infrequent stool.► Constipation is more often cause acute abdominal pain when it is secondary to 1- Anal Fissure 2- Hirschsprung’s Disease 3- Anorectal malformation 4- Neuropathic bowl.► Rectal examination and plain abdominal radiography may helpful in severe cases.
  • 8. Urinary Tract Infection► UTI is an uncommon cause of abdominal pain.► Urinary symptoms vomiting and fever tend to be predominant.► Definitive infection can be confirmed by urinalysis, microscopy and culture.► Sterile pyuria may accompany acute appendicitis► Child with pelviuretic junction obstruction present with acute or recurrent abdominal pain with no urinary symptoms.
  • 9. Gastroenteritis► Itmay cause colicky abdominal pain.► Onset of pain before the diarrhea and presence of lower abdominal tenderness should raise suspicion of appendicitis.► Pelvic tenderness on rectal examination may be useful pointer to appendicitis.
  • 10. Tropical Diseases► Tropical Diseases causing acute abdominal pain are 1- Ascariasis 2- Typhoid 3- Amoebiasis